S Shem

Black Swan, 1985, £7.99, pp 397

ISBN 0 55299 122 8

Rating: **

The House of God has been hanging over my head from the beginning. When I was accepted into medicine, I was given a copy by a helpful fourth year student who told me that I had to read it to understand “what medicine is really like.” So I read it before ever sitting in a lecture, trailing after a ward round, or touching a patient.

The House of God stunned me; I was shocked and angry. I thought of my grandmother dying in hospital while callous doctors laughed about her. If this was medicine I wasnt sure I wanted it anymore. I convinced myself that it simply couldnt be true. I told myself that Shem was a cynic with an overdeveloped imagination and whod had a few bad experiences; I resolved never to become like that. With my faith in medicine restored, I put the book away and got on with becoming a doctor.

The House of God stayed on my shelf until the third year. That was the first chance I had to be on the same ward for more than a few days at a time, on a rotation to a country hospital. In between the emergency department and the medical wards, terms like “gomer” (get out of my emergency room) started to surface, and I was drawn back to the book again. I picked up the book in my last week of the rotation, and this time it made me smile. Id seen doctors joke while doing cardiopulmonary resuscitation and discuss troublesome patients. I felt like I was part of the club; I knew the inside jokes and had even made some myself. I was on my way. Suddenly, though, I was struck with the memory of reading the book the first time. A few short years of medicine had changed me so much that my response to the attitudes and experiences were completely different. I was becoming the cynic who hated medicine and patients; I was turning into the person Id sworn I would never become.

That woke me up, and, over the last two years The House of God has become my Sword of Damocles. Every time I hear a joke about a patient or watch myself talk about what life will be like as a doctor, I think of it. I remind myself how much I dont want to become someone who contributes to the cycle of teaching medical students that the The House of God is real—that patients, hospitals and medicine are the enemy.

So, the week before I graduate, I am again holding The House of God. I havent started to read it yet, because Im a little afraid. What will I think when I read it this time? How will I measure up to it this time? Have I succeeded in keeping myself out of The House of God?